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1-Page Summary of The Fever

Introduction

From 1998 to 2004, malaria cases in Panama increased by four times. In 2010, Europe experienced eight times as many cases of malaria than it had during the previous three decades combined. Between 2003 and 2010, there were 10 times as many bites from mosquitoes carrying malaria-causing parasites than there had been in the preceding decade. Thus, despite advances in public health education and modern medical progress that have made treating malaria easier for doctors and more effective for patients, people are still dying of this disease around the world.

Humans have learned a lot about this disease in the last century, but it still continues to be an issue. The medical community has defeated other diseases such as smallpox and measles, so why is malaria still around? They’re working on finding a solution to eradicate this disease for good.

The Science of Malaria

Malaria is a difficult disease to treat because it’s hard to kill. It has many forms and mutates often, making it more resilient than other diseases. The parasite that causes malaria lives inside its host, which makes treatment more complicated. To defeat the parasite, we need to understand how the disease interacts with its environment — in this case, humans and mosquitoes — not just what makes it work.

Malaria is also a complex illness to attack because it exists in several forms. The parasite that causes malaria, Plasmodium, evolves just like other organisms do. One way it does so is by changing how it uses its host’s body to survive. For non-parasitic illnesses, people can avoid or engage in certain activities to improve their health outcomes. Handwashing and sanitation helped prevent the spread of bubonic plague and avoiding contaminated water decreased outbreaks of typhoid fever.

However, malaria succeeds by forming a relationship with its host. It makes the host more cautious so that it can stay alive longer while the parasite matures inside of it. The parasite forces the mosquito to go after blood less aggressively because doing so would increase its chances of dying prematurely.

When the parasite is young, it changes its strategy. It influences the mosquito to bite more people so that it can get enough blood. As a result, the parasite has access to more victims and meets its needs.

Malaria has plagued humans for a very long time. The disease was especially bad in Africa and Asia, where it infected many humans. In response to the threat of malaria, people developed ovalocytosis, which is a genetic mutation that causes blood cells to be oval-shaped instead of round. Ovalocytosis prevents malaria from spreading in the human body. Humans also developed other mutations that helped them fight off malaria. Once these changes were made, humanity was free from the ravages of this deadly disease until modern times when better transportation allowed mosquitoes carrying parasites to travel around the world more easily than before.

About 2,500 years ago, malaria changed again. The Bantu-speaking peoples moved into the equatorial rainforests and began to change them. This caused some trees to fall and other species of mosquitoes to disappear from the rainforest floor. As a result of these changes, a new type of mosquito carrying an even more harmful form of malaria was born. It spread through human blood cells faster than its predecessor and produced more severe symptoms because it could easily overcome previous genetic mutations that had created barriers for it in earlier times.

In response to malaria, Africans developed sickle-cell gene mutations. Since the time of the ancient world, two copies of this gene caused death in children. However, one copy is survivable and makes a person more resistant to malaria infection. In fact, an individual with only one copy has 90% resistance against P. falciparum compared to someone without it. The mutation offers no other benefits but was preserved by evolution because those who had it were able to survive better than others who didn’t have it during times when there wasn’t advanced medical care available like today’s medicine can provide for people infected with malaria. Today, 40% of the population across Africa, Middle East and South Asia still carry this mutation even though they’re not exposed to as much malaria anymore.

The Fever Book Summary, by Megan Abbott